The effects of Aminophylline on clinical recovery and bispectral index in patients anesthetized with total intravenous anaesthesia.

Sina Ghaffaripour,Hilda Mahmoudi,Mohammad Ali Sahmeddini,Abdolhamid Chohedri,Mohammad Reza Kazemi,Mohammad Bagher Khosravi,Ashkan Rahimi

doi:10.12669/pjms.306.5853

Abstract

Objective: Aminophylline, which is clinically used as a bronchodilator, antagonizes the action of adenosine, so it can be used to shorten the recovery time after general anesthesia. Therefore, we wanted to test the hypothesis that the administration of aminophylline leads to an increase in bispectral index (BIS) and clinical recovery in patients anesthetized with total intravenous anesthesia (TIVA). Methods: Ninety two patients who were scheduled for elective inguinal herniorrhaphy were enrolled in this study. All patients were premedicated with midazolam and morphine. Anesthesia was induced with propofol 2.5 mg /kg and remifentanil 2.5 µg/kg without muscle relaxant. For maintenance of anesthesia we used propofol 100µg/kg/min, remifentanil 0.2µg/kg/min and 100% oxygen with stable BIS readings in the range 40-60. After skin closure, aminophylline 4mg/ kg was given to Group A and an equivalent volume of normal saline to Group P. BIS values, heart rate, blood pressure, oxygen saturation and End tidal CO2(ETco2) were determined. Time to eye opening, extubation time and response to command were measured. Results : There were no significant differences in SpO2, ETco2 and anesthesia time. Heart rate and systolic blood pressure were found to be statistically higher (p<0.001) in Group A. Time to eye opening, hand grip and extubation were significantly shorter (p<0.001) in Group A. Bispectral index scores were significantly higher in group A. Conclusions: Injection of aminophylline at emergence time led to significant increase in BIS and shortening recovery time from anesthesia.

Highlights

The main role of bispectral index (BIS), which was developed from a processed electroencephalogram, is measuring depth of anesthesia and adjusting the Correspondence: June 12, 2014 September 10, 2014 September 15, 2014 dosage of sedating medications.[1,2] The bispectral index ranges from 0 to 100
The main role of bispectral index (BIS), which was developed from a processed electroencephalogram, is measuring depth of anesthesia and adjusting the Correspondence: Sina Ghaffaripour, Shiraz Anesthesiology and Critical Care Research Center, Namazi Hospital, Shiraz, Iran
Emprical evidence suggests that aminophylline, as an adenosine antagonist, can improve the recovery time from general anesthesia.[9,10,11,12]

Summary

INTRODUCTION

Aminophylline is a compound of theophylline with ethylenediamine and most common uses in the airway obstruction such as asthma and COPD.[7,8] emprical evidence suggests that aminophylline, as an adenosine antagonist, can improve the recovery time from general anesthesia.[9,10,11,12] Adenosine is present in all cells and its receptors are distributed in all brain cells.[13,14] Infusion of adenosine in low doses can potentiate the hypnotic effects of anesthetics. Aminophylline can reverse the effect of anesthetics such as benzodiazepines, barbiturates and volatile anesthetics.[16,17,18] The aim of the present study was to investigate the effects of aminophylline on BIS as well as its clinical use in anesthesia recovery from TIVA

METHODS

RESULTS

DISCUSSION